ACEI与长效CCB对高血压脑卒中二级预防的效果分析  

Efficacy analysis of ACEI and long-acting CCB on secondary prevention in hypertension combined with cerebral apoplexy

作　　者：刘国韬 王艾 刘小红 严利南 曾广民 欧阳学逸 刘世芳 邓东明 

机构地区：[1]广东省东莞市南城街道社区卫生服务中心,广东东莞523007 [2]广东省东莞市南城医院,广东东莞523007 [3]广东省东莞市石碣社区卫生服务中心,广东东莞523297

出　　处：《中国当代医药》2015年第12期102-105,共4页China Modern Medicine

摘　　要：目的：探讨ACEI与长效CCB对高血压合并脑卒中二级预防的效果。方法回顾性分析2009年6月~2014年6月社区健康档案中高血压合并脑卒中存活跃2个月的患者863例，以ACEI为降压基础治疗的408例，长效CCB为降压基础治疗的455例，主要观察脑卒中的复发、脑卒中死亡、心肌梗死发生及死亡、总死亡等，观察时间6~70个月，平均39个月。结果两组患者血压下降幅度比较差异无统计学意义（P〉0.05）；两组危险因素干预情况比较差异无统计学意义（P〉0.05）；ACEI组联合利尿剂的患者多于CCB组，差异有统计学意义（P〈0.05）；两组≥2种联合用药率相比，差异无统计学意义（P〉0.05）；ACEI组与CCB组所有脑卒中复发分别为111例（27.2%）、107例（23.5%），差异有统计学意义（P〈0.05）；两组其他心血管事件发生率比较，差异无统计学意义（P〉0.05）。结论降压药对高血压合并脑卒中二级预防的效果与脑卒中一级预防相同，长效CCB优于ACEI。Objective To explore effect of angiotensin converting enzyme inhibitor （ACEI）and long-acting calcium channel blocker （CCB）on secondary prevention in hypertension combined with cerebral apoplexy. Methods Community health files from 863 patients suffered from hypertension with cerebral apoplexy and survived 〉2 months from June 2009 to June 2014 were retrospectively analyzed.ACEI as a basic antihypertensive treatment was applied in 408 cases of ACEI group and long-acting CCB as a basic antihypertensive treatment was adopted in 455 cases of CCB group.In-dexes of recurrence of cerebral apoplexy,stroke death,occurrence and death of myocardial infarction,total death were observed principally.The observation time ranged from 6 to 70 months,at average of 39 months. Results There was no significant difference in blood pressure decrease between two groups（P〉0.05）.Intervention of risk factor didn’t display a statistical difference between two groups （P〉0.05）.Number of patients combined with diuretic in ACEI group was larger than that in CCB group,with statistical difference （P〈0.05）.There was no significant difference in drug combination with two kinds or above between two groups after comparison （P〉0.05）.Frequency of recurrence in stroke in ACEI group and CCB group was 111（27.2%）,107（23.5%）times respectively,with statistical difference（P〈0.05）.Incidence rate of other car-diovascular events were compared,with no significant difference （P〉0.05）. Conclusion Effect of secondary prevention and primary prevention is the same on hypertension combined with cerebral apoplexy by antihypertensive drugs and long-acting CCB is superior to ACEI.

关 键 词：高血压 脑卒中 二级预防 规范治疗 长效钙拮抗剂 血管紧张素转换酶抑制剂 

分 类 号：R743.3[医药卫生—神经病学与精神病学]